Johns: Chest X-ray

Question 1

What are the ABC’s of chest x-ray interpretation?

Answer 1

A- Airway and adenopathy
B- Bones and breast shadows
C- Cardiac Silhouette
D- Diaphragm
E- Everything around the lung fields
F- Fields (lung fields)

Question 2

Ascending aorta obscured?

Answer 2

RUL

Question 3

Left heart border obscured?

Answer 3

Lingula

Question 4

Right heart border obscured obscured?

Answer 4

RML

Question 5

Upper part of left heart border obscured?

Answer 5

Left upper lobe

Question 6

Upper part of right heart border obscured?

Answer 6

RUL

Question 7

Aortic arch obscured?

Answer 7

LUL

Question 8

Right heart border obscured?

Answer 8

Anterior mediastinum

Question 9

Why are chest CTs done?

Answer 9

1. Evaluate lung masses or nodules seen on CXR
2. Check for PE
3. Define unkown abnormalities

Question 10

What are the biggest differences in Chest CT vs. CXR?

Answer 10

1. CXR 100, 10 mili rem radiation

2. CT- 1,500, 580 milli rem

Question 11

What is a standard x-ray?

Answer 11

Posterior to anterior

Quality of PA is better than AP

Question 12

When is an AP x-ray commonly used?

Answer 12

Portable x-ray if a pt is unable to stand

Heart is artificially enlarged on an AP

Question 13

What are important characteristics to note when looking at an xray?

Answer 13

1. Rotation (Trachea midline, Clavicles equidistance from the midline)
2. Diaphragm shows adequate inspiratory effort, and costophrenic angles
3. Vertebrae vaguely visible behind the heart

Question 14

Why do we do a lateral CXR?

Answer 14

1. To look behind the heart
2. Anterior Clear space
3. If something is wrong, vertebrae will appear white to black to white again (pneumonia, fluid, tumor)